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Comparative Effects of Blood Flow Restriction Resistance Training Versus Blood Flow Restriction Cycling on Pain, Quadriceps Strength, and Functional Outcomes in Athletes With Patellofemoral Pain (BFR-PFP-RCT)

23 juni 2026 uppdaterad av: Hafsah Gul Khattak, Ibadat International University, Islamabad

Comparative Effects of Blood Flow Restriction Resistance Training Versus Blood Flow Restriction Cycling on Pain, Quadriceps Strength, and Functional Outcomes in Athletes With Patellofemoral Pain: A Randomized Controlled Trial

This randomized controlled trial compares blood flow restriction (BFR) resistance training (leg press and seated knee extension at 30% 1RM) versus BFR cycling (stationary cycling at low resistance) in 60 athletes (aged 18-40 years) diagnosed with patellofemoral pain syndrome. Both interventions are delivered over 8 weeks (3 sessions/week) with a pneumatic cuff set at 80% limb occlusion pressure. Primary outcomes include pain intensity (NPRS), quadriceps strength (handheld dynamometer), and functional ability (Kujala Anterior Knee Pain Scale), assessed at baseline and post-intervention.

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Patellofemoral pain (PFP) is among the most prevalent musculoskeletal conditions in athletes, with reported prevalence of 30-40% in sports populations. High-load resistance training is the conventional rehabilitation approach but often exacerbates joint stress and reduces adherence. Blood flow restriction (BFR) training enables strength gains at low loads by applying a pneumatic cuff at 80% LOP on the proximal thigh.

This trial compares two BFR modalities:

  • Group A (BFR-RT): Leg press and seated knee extension, 1x30 + 3x15 reps at 30% 1RM, 3x/week for 8 weeks.
  • Group B (BFR-CYC): Stationary cycling at low resistance, 4x5-minute intervals at 70-80 RPM (RPE 11-13), 3x/week for 8 weeks.

All sessions are supervised one-on-one by a physiotherapist. Assessments are conducted at baseline and week 8. The study is single-blinded (outcome assessor blinded). Randomization via computer-generated sequence. Statistical analysis via SPSS v27 (paired t-test / Wilcoxon for within-group; independent t-test / Mann-Whitney for between-group, alpha=0.05).

Studietyp

Interventionell

Inskrivning (Beräknad)

48

Fas

  • Inte tillämpbar

Kontakter och platser

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Studiekontakt

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Studieorter

  • Pakistan
      • Islamabad, Pakistan, 46000
        • Rekrytering
        • Ibadat International University, Islamabad (Iiui)
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  1. Male and female athletes aged 18-40 years
  2. Clinically diagnosed with patellofemoral pain syndrome
  3. Anterior or retropatellar knee pain of at least 3 months duration
  4. Pain provoked by at least two functional activities (e.g., squatting, stair climbing, running, prolonged sitting)
  5. Willingness to participate and provide written informed consent

Exclusion Criteria:

  1. History of knee surgery or significant knee trauma in the past 6 months
  2. Presence of ligament, meniscal, or cartilage injuries
  3. Neurological, vascular, or systemic inflammatory conditions
  4. Contraindications to BFR training (e.g., deep vein thrombosis, uncontrolled hypertension)
  5. Pregnancy

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: BFR Resistance Training Group
Participants perform leg press and seated knee extension exercises at 30% of 1RM with a pneumatic cuff (12 cm wide, Delfi Medical) applied to the proximal thigh at 80% limb occlusion pressure (LOP). Protocol: 1 set of 30 + 3 sets of 15 repetitions, with 60-second rest between sets (cuff deflated). Frequency: 3 sessions/week for 8 weeks (24 sessions total). 1RM re-estimated every 2 weeks for progressive load adjustment. Warm-up: 10 min low-resistance cycling (no BFR). Cool-down: 5 min lower-limb stretching.
Enhet: Blood Flow Restriction Resistance Training
Participants will undergo blood flow restriction (BFR) resistance training using a pneumatic cuff applied to the proximal thigh at 80% limb occlusion pressure. Exercises include leg press and seated knee extension performed at 30% of one-repetition maximum (1RM). Training will be conducted for 8 weeks, with supervised sessions 3 times per week. Cuff pressure will be monitored and adjusted using BP cuff. The aim is to improve quadriceps strength and reduce pain in patients with patellofemoral pain.
Experimentell: BFR Cycling Group
Participants perform stationary cycling at low resistance targeting RPE 11-13, with a pneumatic cuff (12 cm wide, Delfi Medical) applied to the proximal thigh at 80% LOP. Protocol: 4 x 5-minute cycling intervals at 70-80 RPM, with 1-minute rest between intervals (cuff deflated). Frequency: 3 sessions/week for 8 weeks (24 sessions total). Cadence increased by 5 RPM if RPE <11. Warm-up: 10 min low-resistance cycling (no BFR). Cool-down: 5 min lower-limb stretching.
Enhet: Blood Flow Restriction Cycling
Participants will perform stationary cycling combined with blood flow restriction (BFR) applied to the proximal thigh at 80% limb occlusion pressure. Cycling will be performed at low resistance with controlled cadence for 8 weeks, 3 sessions per week under physiotherapist supervision. The protocol includes structured cycling intervals with rest periods and continuous monitoring of pain and perceived exertion. The intervention aims to improve quadriceps strength, reduce pain, and enhance functional outcomes in patients with patellofemoral pain.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Quadriceps Strength - Handheld Dynamometer
Tidsram: Baseline (Week 0) and Post-intervention (Week 8)
Isometric quadriceps muscle strength measured in Newtons using a calibrated handheld dynamometer (ICC > 0.90). Measurement taken in a standardized seated position at 60° knee flexion.
Baseline (Week 0) and Post-intervention (Week 8)
Pain Intensity - Numeric Pain Rating Scale (NPRS)
Tidsram: Baseline (Week 0) and Post-intervention (Week 8)
Self-reported pain intensity rated on a 0-10 scale (0 = no pain, 10 = worst imaginable pain). The NPRS has excellent test-retest reliability (ICC 0.95).
Baseline (Week 0) and Post-intervention (Week 8)

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Functional Outcomes - Kujala Anterior Knee Pain Scale (AKPS)
Tidsram: Baseline (Week 0) and Post-intervention (Week 8)
13-item patient-reported outcome measure assessing functional limitations due to anterior knee pain. Scored 0-100 (higher = better function). High internal consistency (α = 0.83-0.91).
Baseline (Week 0) and Post-intervention (Week 8)

Samarbetspartners och utredare

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Sponsor

Ibadat International University, Islamabad

Utredare

  • Huvudutredare: Hafsah Gul Khattak, DPT, MS-NMPT, Ibadat International University, Islamabad (Iiui)

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

10 maj 2026

Primärt slutförande (Beräknad)

10 juli 2026

Avslutad studie (Beräknad)

25 juli 2026

Studieregistreringsdatum

Först inskickad

7 maj 2026

Först inskickad som uppfyllde QC-kriterierna

7 maj 2026

Första postat (Faktisk)

13 maj 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

26 juni 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

23 juni 2026

Senast verifierad

1 juni 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • IIUI/RERC/ADT/2026/04/286

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